Psychiatry

Psychiatry

Psychiatrist sits with notebook on lap and talks to person seeking treatment, rear view shows short curly blonde hairPsychiatry is the field of medicine dedicated to the study and treatment of mental health conditions. A person trained and credentialed to practice this type of medicine is called a psychiatrist. Psychiatrists may treat mental health conditions that interfere with daily functioning, such as depression and anxiety, and may also treat mental health conditions caused by physical injuries, such as traumatic brain injury.

Addiction psychiatry, community psychiatry, child psychiatry, and social psychiatry are just a few of the specialty fields psychiatrists might practice in. Some people seeking therapy may choose to see a psychiatrist, while others may be referred to a psychiatrist by their therapist or counselor. 

Understanding Psychiatry

The field of psychiatry has existed, in one form or another, for thousands of years.

  • In ancient Greece and Rome, mental health conditions were largely believed to be caused by supernatural forces, until Hippocrates suggested in the 4th century B.C.E. that they might instead be caused by physiological concerns.
  • In the Middle Ages, people with mental health conditions were typically placed in asylums where they ostensibly received treatment. However, these institutions were often more likely to serve as holding facilities than as treatment hospitals. 
  • In the 18th century, French psychiatrist Philippe Pinel began to work for humane treatments for psychiatric patients. Conditions for those installed in asylums continued to vary greatly well into the 20th century.

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  • At the turn of the 20th century, psychiatrists began proposing different treatment modalities. Throughout the 20th century, mental health conditions have increasingly come to be viewed and understood to be highly treatable. However, psychiatric hospital conditions and protocols can still vary, depending on location, issues treated, and other factors. 

Psychiatrists may differ in their treatment philosophy, but the field of psychiatry works from the belief that mental health conditions have an underlying biological cause. Psychiatrists prescribe medications to correct imbalances in brain chemistry that cause mental health symptoms. Although most psychiatrists prescribe medication as part of treatment, some also offer other types of treatment, such as talk therapy. 

Psychiatry, Psychology, and Psychotherapy

A psychiatrist is a medical doctor—either a doctor of medicine (MD) or a Doctor of Osteopathic Medicine (DO)—who has graduated from medical school and completed specialized training in psychiatric care. Because psychiatrists are trained as doctors, they can treat both the mental and physical aspects of mental health conditions, and they can also prescribe medication. 

A psychologist, on the other hand, has a doctoral degree—a PhD or a PsyD—‚Äčin the field of psychology and is trained to both provide talk therapy and psychological assessment but (in most states) is not licensed to prescribe medications. Psychologists are not medical doctors, and they often refer the people in their care to psychiatrists or other medical providers, in the event they recognize the possible presence of any physical issues that may be contributing to mental health issues. 

Psychotherapy is a broad term that may refer to any type of talk therapy. Psychotherapy can be practiced by people with a wide range of training and credentials, such as psychiatrists, psychologists, counselors, marriage and family therapists, and social workers, among others. 

When Is a Psychiatric Approach Recommended?

While many people with a mental health condition benefit greatly from therapy, not all concerns can be treated with therapy alone. Depression, anxiety, PTSD, and other conditions may sometimes be so debilitating that medications may be advised in order for a person to better manage their condition and health. Additionally, some severe and persistent conditions, such as schizophrenia and bipolar, may occasionally require treatment with medication for the purpose of safety and/or stability. In such cases, psychiatry is often recommended. Although no single treatment approach works for everybody, it may be helpful to consult with a qualified medical professional to see if psychiatry, and specifically the use of medications, may be helpful.

Any individual who is seeking psychiatric care has the right to ask questions about the recommended course of treatment and to also seek information about possible alternative treatments that might also be effective and beneficial. Sometimes medications used to treat mental health conditions can be managed by a primary care physician or other medical provider. When the condition is complex or otherwise difficult to treat, seeing a psychiatrist may be the recommended course of action. While all doctors can prescribe medications, psychiatrists are specifically trained to treat mental health issues; thus, they may be able to provide a level of experience and expertise other types of doctors cannot. 

Philosophy of Psychiatric Treatment

Psychiatrists generally rely on the use of medications, possibly in conjunction with other treatments, to treat mental health issues. While medications can certainly be beneficial, they are not without risks. Side effects, which can range from mild to severe, are common. Additionally, the use of medications may not be necessary, as some research suggests that antidepressants and other medications are no more effective than therapy in many cases. 

Although psychiatrists commonly recommend medication, each individual has the right to make their own decisions about the type of treatment they want. When providing treatment, a psychiatrist has an ethical and legal obligation to obtain informed consent from a person in their care. This means the psychiatrist must explain what treatment they will be providing and the potential risks and benefits of that treatment, so individuals can make an informed decision about whether they want to participate in the treatment or not.

Furthermore, psychiatrists cannot force people to participate in treatment or take medications, except in some rare cases. Any individual who is seeking psychiatric care has the right to ask questions about the recommended course of treatment and to also seek information about possible alternative treatments that might also be effective and beneficial. 

References:

  1. Amer, A. B. (2013). Informed consent in adult psychiatry. Oman Medical Journal, 28(4). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3725243
  2. American Psychiatric Association. (n.d.). What is psychiatry? Retrieved from https://www.psychiatry.org/patients-families/what-is-psychiatry
  3. American Psychological Association. APA concise dictionary of psychology. Washington, DC: American Psychological Association, 2009. Print. 
  4. Cherry, K. (2016, April 20). Who can provide psychotherapy? Retrieved from https://www.verywell.com/who-can-provide-psychotherapy-2795763
  5. Kring, A. M., Johnson, S. L., Davison, G. C., & Neale, J. M. (2010). Abnormal psychology. Hoboken, NJ: John Wiley & Sons.
  6. Shorter, E. (1997). A history of psychiatry: From the era of the asylum to the age of Prozac. New York, NY: John Wiley & Sons.

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